IVF insurance question


#1

Hi

I am thinking about doing ivf. I have been going to rmia in edina/woodbury in MN however they don’t *participate with any insurance for ivf. *They will be considered out of network. *For iui they are in network and my insurance has been paying for most of that. *I have blue cross and they will pay $12000 towards infertility treatments. * *For what I have gathered from rmia *and blue cross. Is I need to pay upfront for ivf. *Than rmia will submit claims to blue cross. *Than blue cross will submit any payment for coverage back to rmia. According to blue cross they never pay out money to people only to the clinic. *However rmai says usually they have seen insurance companies pay the person. * I have gotten all the codes for ivf procedures from rmia. *Blue *cross is sending me a letter to what would be paid. **I guess I am worried that in the end of this whole process with *insurance it won’t work out correctly and I’ll end up paying for the whole procedure out of pocket. *Has anyone had rmia or any other clinic pay them money after insurance reimbursed the clinic? * *


#2

[quote=Am_ready]Hi

I am thinking about doing ivf. I have been going to rmia in edina/woodbury in MN however they don’t *participate with any insurance for ivf. *They will be considered out of network. *For iui they are in network and my insurance has been paying for most of that. *I have blue cross and they will pay $12000 towards infertility treatments. * *For what I have gathered from rmia *and blue cross. Is I need to pay upfront for ivf. *Than rmia will submit claims to blue cross. *Than blue cross will submit any payment for coverage back to rmia. According to blue cross they never pay out money to people only to the clinic. *However rmai says usually they have seen insurance companies pay the person. * I have gotten all the codes for ivf procedures from rmia. *Blue *cross is sending me a letter to what would be paid. **I guess I am worried that in the end of this whole process with *insurance it won’t work out correctly and I’ll end up paying for the whole procedure out of pocket. *Has anyone had rmia or any other clinic pay them money after insurance reimbursed the clinic? * *[/quote]

Well, it is possible that you could end up paying for IVF if your RE is not in the network. Is there another RE that you could go to? I know that you probably do not want to change, but usually with insurance, if you are lucky enough to have fertility coverage, it is approved prior to starting a cycle.


#3

To get the best bang out of your insurance would be to go to a provider that participates with your insurance company. If your re requires for you to pay their full fee upfront for services and will then file your claims for you, the payment should go to you since they are not accepting assignment of benefits. Worst case, if the payments go to your re you should obviously be refunded that money from them. You may be sorely dissapointed at what you get from your insurance company by going to a provider that does not participate. My re charges $350 per ultrasound and my insurance company reimburses me $83…because he is out of network. If I went to someone in network I wouldn’t be paying anything. I wish the reimbursement was better but it’s better than nothing I guess! Good luck to you!


#4

Yes I am going to talk with anoother place. One that does except my insurance. And they don’t require up front payment. I hate to change places but it’s so much cheaper to go to the other place.